7.asthma and bisinosis

Question 1

Clinical presentation

Answer 1

Dyspnea - expiratory

Question 2

Findings on auscultation

Answer 2

Wheezing

Question 3

Findings on percussion

Answer 3

Hyperresonance

Question 4

Reasons for asthma

Answer 4

1.bronchial edema
2.mucus secretion
3.bronchospasm

Question 5

Findings in patients

Answer 5

1.difficult gas exchange (difficult to get air in and out)
2.air trapping
3.hyperinflation

Question 6

Atopic triad

Answer 6

1.allergies
2.atopic dermatitis
3.asthma

Question 7

samters triad

Answer 7

Allergy to aspirin is present

Question 8

Causes

Answer 8

1.aspirin
2.beta blockers
3.infections - viral
4.cold air
5.exercise

Question 9

Pathophysiology

Answer 9

1. Ag is picked up by dendritic cells and presented to Th2.
2. Th2 releases cytokines (IL4,5)
3. Cytokines stimulate cells
   *-eosinophils:bronchoconstriction
   *-plasma cells:IgE - mast cell degranulation - histamine and leukotrienes release
   =increased mucus/edema
   —AIRWAY OBSTRUCTION

Question 10

bronchial asthma definition

Answer 10

chronic inflammatory airway disease
with participation of mast cells and eosinophils
and bronchial hyperreactivity

-reversible

Question 11

etiology

Answer 11

1.allergies: dust mites in agriculature,mining
2.exposure to high molecular proteins (animal, plant products)
3.exposure to low molecular weight chemicals that acts as haptens in food,wine,tobacco industries
4.hair dressing/pains
5.production,packing,usage of drugs like aspirin,NSAIDS

Question 12

classification

Answer 12

1.intermittent - symptoms occur less than 2x weekly
2.persistent
2.1mild - more than 2x weekly
2.2middle - daily
2.3severe - daily and at night

Question 13

pathogenesis

Answer 13

allergic
caused by different organic substances
at a contact with specific Ag , IgE binds to mast cell and cause its degranulation (histamines)
-increased bronchoconstriction and mucus secretion

non
caused by low weight molecules that act as haptens
repeated exposure to industrial chemicals cause release of leukotrienes that cause bronchoconstriction

Question 14

clinical manifestation of asthma

Answer 14

1.expiratory dyspnea
2.difficult expectoration of еlastic sputum during attack
3.restlessness
4.short term chest pain
5. decreased FVC

Question 15

diagnosis of asthma

Answer 15

1.work environmental history
2.skin allergy test
3.bronchoprovocation test: FEVC decreased after respiratory provocation
4.bronchodilation test : positive if FEVC is increased by 20% when salbutamol used
5.exclusion of upper respiratory tract infections

Question 16

dd of bronchial asthma

Answer 16

1.copd
2.congestive heart failure
3.laryngeal obstruction
4.chronic sinusitis

Question 17

treatment of bronchial asthma

Answer 17

1.bronchodilatory - beta agonists
2.anti-inflammatory - corticosteroids

Question 18

What is bisinosis?

Answer 18

occ. lung disease caused by inhalation of cotton dust or dust from fibres like flax

Question 19

etiology of bisinosis

Answer 19

industrial processing of textiles

Question 20

pathogenesis of bisinosis

Answer 20

1.exposure causes immediate release of
-inflammatory mediators are released
triggering an immune response + bronchoirritation
2. cotton dust also contains endotoxins from the gram- bacteria present in cotton fibers
they further cause irritation

Question 21

symptoms in bisinosis

Answer 21

1.chest tightness
2.cough
3.wheezing

Question 22

diagnosis of bisinosis

Answer 22

1.work environmental history
2.allergy test
3.radiography
4.functional test

Question 23

dd of bisinosis

Answer 23

1.chronic bronchitis
2.inhalation fever

Question 24

treatment

Answer 24

1.o2 therapy and breathing exercises
2.corticosteroids + bronchodilators
3.wear face masks
4.quit smoking